Lipid accumulation product and insulin resistance in Iranian PCOS prevalence study

Summary Objective To evaluate diagnostic accuracy of lipid accumulation product ( LAP ) index as a marker of insulin resistance in a community‐based population with polycystic ovary syndrome ( PCOS ), compared with healthy women. Methods Anthropometric measurements, biochemical parameters, LAP index and insulin resistance ( IR ) were compared in 134 PCOS subjects and 414 healthy women recruited from 1126 reproductive aged women (18–45 years), participants of the Iranian PCOS Prevalence Study. LAP was defined as [ WC (cm)–58] × TG (mmol/l)]. PCOS was diagnosed using the Rotterdam criteria, and IR was defined using the homeostatic model assessment IR . LAP , body mass index ( BMI ), waist circumference ( WC ) and waist‐to‐hip ratio ( WHR ) were compared using the two‐tailed Spearman rank correlation test and analysing the receiver operating characteristic ( ROC ) curves for IR . Results Among the PCOS subjects, the mean ±  SD age, BMI , WC and WHR were 32·2 ± 7·7 years, 26·8 ± 5·8 kg/m 2 , 85·2 ± 13·2 cm and 0·80 ± 0·06, respectively, and the median ( IQ 25–75) of LAP index was 34·03 (17·8–66·3). There was significant correlation between HOMA ‐ IR index and LAP in patients with PCOS (r = 0·41; P  <   0·001). Also, ROC curves analysis revealed that the optimal cut‐off value for LAP to define the presence of IR was 34·1 (sensitivity: 75%; specificity: 58%). LAP showed the highest area under curve ( AUC ) ( P  <   0·001). Conclusion Among PCOS subjects, LAP index has the strongest diagnostic accuracy for detection of IR in comparison with BMI , WC and WHR .